Young Physicians: Burnout in Emergency Medicine and How to Prevent It

Burnout in Emergency Medicine and How to Prevent It

Alveena Dawood, MD

The term “burnout” is becoming increasingly more common in medicine over the past several years. As medical care continues to become more complex, a significant portion of that burden begins to fall on physicians, especially the physicians on the front lines. Taking care of medically complex patients, charting in electronic medical records in real time, satisfying metrics, meeting the needs of family members, working under resource-scarce environments, and trying to meet patient satisfaction goals are just a few reasons why burnout is high in emergency medicine. These pressures in medicine can be immense. This past year has brought on even more unique challenges. Struggling with the COVID-19 pandemic has further stretched emergency medicine physicians. Historically in medicine, admitting to feeling “stressed out” or “overwhelmed’ has been viewed as a sign of weakness. This has propagated a malignant culture where physicians overwork themselves in fear of being inadequate, and subsequently, end up hurting themselves. It is time for that to change. It has been increasingly apparent that in order to properly care for patients, we must also care for ourselves.

Study after study continues to find emergency medicine as the highest ranked specialty for physician burnout. The fast pace, high acuity, the constant unknown, high volumes with often low resources all contribute to the immense difficulty of this specialty. Shanefelt et al. found emergency medicine in their 2012 study to rank highest in physician burn out rates at 65%, 10% greater than the next specialty (general internal medicine).4 Medscape releases an annual survey of physician burnout rates since 2013, and it has shown a gradual rise in physician reported burnout rates year after year. Most recent data showed that as high as 44% of physician reported feeling burnt out.3 This is alarming. Physician burnout can lead to multiple consequences. When physicians start feeling burnt out, it can start off by affecting their clinical practice i.e. losing empathy for patients, making medical errors, and not being able to connect with patients the way you once did. This ultimately leads to patient dissatisfaction as well as patient harm. Furthermore, not only is clinical practice affected, your personal life suffers too. Relationships, friendships, and your personal well-being are all at stake. Physicians often turn to substance abuse, suffer from depression, leave the profession they once loved, or sadly turn to suicide. The general public is often surprised to hear when a young physician has committed suicide since doctors are generally held to a high standard in society. How can someone who has devoted their life to saving the lives of others take their own? It is mostly due to a complex and broken system; however, we as physicians can take steps to save ourselves, and in turn, our patients. Wellness in emergency medicine is, plain and simple, extremely important. In order to take care of your patients well, you have to take care of yourself first. 1. Start off by making time for yourself. It can be easy to fall into the same mundane routine of work and home. Make sure to schedule time every day, even if just 30 minutes, to do something you enjoy. Read books, take time to exercise, hike, yoga, go out with friends, cook, anything to destress from daily life. Take off time to go on trips with friends and decompress from medicine. 2. Find a good support network; whether a group of individuals at work or friends from another time in your life. It is important to be able to talk to someone about difficult cases you have had at work. 3. Get involved in a project that excites you. Whether it is work related or completely unrelated to medicine, have a task that you can look forward to working on. 4. Sleep hygiene can also be difficult to achieve in the field of emergency medicine. However, it remains just as important so you don’t fall victim to the challenges of sleep deprivation. Use the usual sleep hygiene techniques; no caffeine or alcohol prior to a good night’s rest. After overnight shift, sleep in a dark and quiet room or use ear plugs, white noise machines, and blackout curtains if possible. Try suggesting circadian rhythm schedules if your group does not already employ them. Schedule naps during the day to catch up on your sleep debt, especially before your overnight shifts. 5. If you find yourself struggling with work and life balance, and none of these previous techniques seem to be helping you, reach out. Talk to your director or seek out any wellness resources your hospital and/or group may offer. Seek professional help if you find yourself continuing to struggle. It is not a sign of weakness, but rather strength to admit when you know that you need help. 

Study after study

continues to find emergency medicine as the highest ranked specialty for physician burnout.”